Incidence of Femoral Component Malrotation Using Posterior Condylar Referencing in Total Knee Arthroplasty.

Autor:	Lee DK; Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York., Grosso MJ; Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York., Trofa DP; Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York., Sonnenfeld JJ; Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York., Cooper HJ; Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York., Shah RP; Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York., Geller JA; Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, New York.
Jazyk:	angličtina
Zdroj:	The journal of knee surgery [J Knee Surg] 2020 Oct; Vol. 33 (10), pp. 971-977. Date of Electronic Publication: 2019 May 20.
DOI:	10.1055/s-0039-1688931
Abstrakt:	Proper femoral component rotation in total knee arthroplasty (TKA) is important, given the prognostic impact of a poorly positioned component. The purpose of this observational study was to determine the incidence of femoral component malrotation using posterior condylar axis (PCA) referencing. A total of 100 knees in 92 patients with varus gonarthritis of the knee undergoing primary TKA using a standard medial parapatellar approach were evaluated intraoperatively. After distal femoral resection, the standard femoral sizing guide referencing the posterior condylar axis was used to set femoral component rotation. This was then compared with both the transepicondylar (TEA) and trochlear anteroposterior axes (TRAx). Disparites were recorded and corrected in line with the epicondylar axis. Rotational adjustment for addition of further external rotation was made in 13 (13.0%) cases. In seven cases, the medial pin sites were raised between 1 and 3 mm, and in six cases, the lateral pin site was lowered between 1 and 3 mm (based on risk of notching the femoral cortex). It is critical to not rely exclusively on the PCA to confirm rotational positioning of the femoral component as predicted by posterior condylar referencing guides. Intraoperative adjustment and confirmation using the TEA and TRAx occurred in 13% of primary TKA cases, which might have, otherwise, had a significant effect on the clinical outcome. Competing Interests: H.J.C. reports other from AAOS, personal fees from DePuy, other from Journal of Arthroplasty, other from Journal of Bone and Joint Surgery–American, grants, personal fees and other from KCI/KCI Medical Canada/KCI USA, Inc., personal fees from Zimmer-Biomet, personal fees from OnPoint Knee Inc, other from Smith & Nephew, outside the submitted work. J.A.G. reports other from CORR, grants from OSRF, grants from Orthosensor, grants and personal fees from Smith and Nephew, other from Journal of Arthroplasty, outside the submitted work. (Thieme. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu